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A comprehensive synthesis of available literature and current state policies and practices regarding child-only cases provided context for both secondary analysis and case studies. The goals of the comprehensive literature review include
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The study team first reviewed recent studies characterizing child-only cases. Of particular interest were several studies examining this population in the context of state policies in California, Delaware, Florida, Missouri, New Jersey, North Carolina, and South Carolina. Because states have implemented a variety of approaches to address child-only cases with relative caregivers, staff reviewed the most recent annual state TANF plan for all 50 states and Washington, DC. To complement the review of state TANF plans, staff also conducted phone conversations with regional administrators of the Administration for Children and Families. Study staff used these conversations to verify information obtained through the TANF state plans and to identify state initiatives addressing child-only relative caregiver cases. Finally, as a context for understanding the needs of children in TANF child-only cases with relative caregivers, the study team reviewed literature on the broader population of children in relative care, focusing on children's needs and well-being.
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A child-only TANF case is one in which no adult is included in the cash grant (Wood and Strong, 2002). A case can come to be classified as a child-only case in a number of ways; however, these classifications can be grouped into two large categories: (1) child-only cases with nonparent caregivers and (2) child-only cases with parent caregivers (Farrell et al., 2000; Duncan, 2002).
A child-only TANF case is one in which no adult is included in the cash grant.
One type of child-only case occurs when a child is living somewhere other than with a parent (i.e., with a relative) and the relative receives benefits on behalf of the child. While the child is residing with the relative, the relative might not have formal, legal custody of the child. Current National Survey of America's Families (NSAF) data indicate increasing numbers of children being cared for by relatives (Ehrle and Geen, 2002). Because they have no legal obligation to raise these children, nonparent caregivers have the option of receiving a child-only TANF grant (Harvard Law Review, 1999). The amount of this grant and the specific eligibility requirements differ by state. Additionally, nonparent caregivers may choose to be included in the assistance unit, if eligible, and receive benefits for both the child and themselves. In this case, the child is no longer considered to be in a child-only case.
|There are a number of ways a case can come to be classified as a child-only
case. These cases group themselves into two distinct groups:
There are three situations in which the children can be living with one or both parents, but the parents are not included in the assistance unit:
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With the passing of PRWORA in 1996, much control of the public welfare system has devolved to states. Decentralization, state control, and the proliferation of different approaches to eligibility, work requirements, and time limits were among the intended consequences of the legislation (Blum and Francis, 2002; Hegar and Scannapieco, 2000). States have responded to PRWORA with a variety of welfare rules, services, and benefits, making it difficult to evaluate and analyze what is behind national trends as they occur (U.S. GAO, 2002).
|TANF child-only cases have more than doubled as a share of the TANF caseload, from about 10 percent to more than 20 percent from 1996 to 2001.|
One such trend is that of the increasing proportion of child-only cases in the TANF caseload. While the number of child-only cases has fluctuated over time, their proportionate share of the TANF caseload has increased, as shown in Figure 2-1. The number of child-only families increased steadily throughout the middle 1990s, reaching a peak of 978,000 such families in fiscal year 1996. Through fiscal year 1998, the number of child-only families decreased to 743,000, although their proportion of the caseload continued to increase slowly to 23.4 percent from 21.5 percent in FY 1996. Since fiscal year 1998, both the number and the proportion of child-only cases have increased each year, with approximately 786,932 child-only cases in fiscal year 2001, comprising 37.2 percent of the total TANF caseload. Therefore, while child-only cases have not grown consistently in absolute numbers, they are becoming an increasing proportion of the overall TANF caseload.
Number of Child-Only Cases and Proportion of the TANF Caseload.
Sources: Charlesworth et al., (n.d.); DHHS, 2002a; DHHS, 2003.
Of the 786,982 child-only cases in FY 2001, just over 50 percent are child-only cases in which someone other than the parent is caring for the child (typically a relative). The focus of this study is on these child-only cases with relative caregivers.
While the increase in child-only cases across the nation has caught the attention of both federal and state officials, variations in related rules, services, and benefits make them difficult to assess at the national level. As a result, several recent studies have concentrated on characterizing and examining child-only cases at the state level.
Increasing proportions of child-only cases are seen in caseloads reported by other states, although patterns vary dramatically among states. Child-only cases represent a major share of the TANF caseload in some states and a much smaller proportion in others. As depicted in Table 2-1, in 2001, child-only cases made up more than half the TANF caseloads in seven states (Alabama, Florida, Idaho, North Carolina, South Dakota, Wisconsin, and Wyoming) and 45 to 50 percent in eight others (Arizona, Georgia, Louisiana, Mississippi, Nevada, Oklahoma, Oregon, and South Carolina). In the same year, however, child-only cases made up less than 20 percent of the TANF caseloads in four states (Alaska, Hawaii, Rhode Island, and Vermont) (DHHS, 2003).
|State||Total Families||Child-Only Families||Percent|
|District of Columbia||16,337||4,280||26.2|
|Sources: DHHS, 2003.|
Many states have seen an increase in their TANF child-only caseloads. Montana reported an increase of 15 percent in their child-only caseload from 2000 to 2001, Arizona reported an increase of 16 percent from July 2000 to July 2001, and Pennsylvania reported an increase (although slight) each month since July 2001(DHHS, 2002b). Additionally, Nevada reported an increase of 8 percent in their child-only caseload for fiscal year 2001. Iowa reported a 3 percent increase; Nebraska, a 3.3 percent increase; Kansas, a 3.8 percent increase; and Missouri, a 6.7 percent increase during the same time period (DHHS, 2002b).
A critical caveat to better understanding the growth of child-only cases is while the proportion of child-only cases is increasing nationally, the absolute number is relatively stable, from 743,000 in fiscal year 1998 to 787,000 in fiscal year 2001 (DHHS, 2002b). In fact, in many states child-only cases have remained stable, if not declined (Edelhoch, 2002; Farrell et al., 2000; Wood and Strong, 2002; Schofield and Fein, 2000) in the past several years, although a few states have had modest absolute increases in their child-only caseloads. No state is able to identify a single reason for the proportional increase in child-only cases, but the significant decline in the general TANF caseload appears to be the largest factor (from 4,553,000 in fiscal year 1996 to 2,121,000 in fiscal year 2001) (DHHS, 2002b).
As research continues to document a growing proportion of child-only cases across the nation, federal and state officials have sought an explanation for this phenomenon. The issue is of particular interest in light of concerns early in the implementation of welfare reform that parents might place children with relatives to escape rigorous TANF work requirements (Duncan, 2002). The stable number of child-only cases suggests that welfare reform has not led to a large amount of "child-shifting" from parents to other relatives to access financial support for children after adult recipients lose their benefits (Farrell et al., 2000).
Several situations affecting the number of parental child-only cases offer possible explanations for the proportional growth of child-only cases overall. These include the following (Farrell et al., 2000):
Table 2-2 and Table 2-3 present data collected and presented for the Fifth Annual TANF Report to Congress (DHHS, 2003). Each table presents information for the period from October 2000 through September 2001. Both tables depict the variation in the composition of child-only cases among states.
Table 2-2 summarizes reasons that parents may be living in the household but not considered eligible for cash assistance through TANF. Although not all states provide detailed data, those that do show substantial variation in the distribution of parental-caregiver cases. As depicted in Table 2-2, almost half (49.5 percent) of child-only cases in the United States are cases in which the parent is present as a caregiver but not included in the assistance unit. Of these child-only cases, the majority (42.1 percent) are those in which a parent is not in the assistance unit due to having qualified for SSI benefits. The smallest portion of these cases (9.7 percent) is due to parent(s) being sanctioned and removed from TANF eligibility.
Composition of the child-only caseload varies among states as a result of policy and demographic variations. For example, California reports 69 percent of their total child-only cases are parental caregiver cases, with the majority of these due to parental citizenship status (DHHS, 2003). The 15 states in which the majority of child-only cases are parental include many of the states with the largest child-only caseloads (i.e., California, New York, Texas). Many of these states have substantial immigrant populations. Thirty states report that fewer than half of their child-only cases are parental. Among these states Alabama, Alaska, Iowa, Idaho, Hawaii, Nevada, Oklahoma, and Oregon all report fewer than 10 percent of child-only cases have parents present but not in the assistance unit.
|State||Child-Only Families (Number)||CO Families with Parents||Reason Why Parents Are Not in AU (Percent)|
|Number||Percent of All Child-Only Families||Sanction||SSI Benefit||Citizenship||Other|
|District of Columbia||4,280||2,101||49.1||53.5||28.8||5.6||12.1|
|Sources: DHHS, 2003.|
Sanctioning policies vary among states. For example, some states begin the sanctioning process by removing the adult from the grant; however, after a brief transition period the state implements a "full family" sanction (Wood and Strong, 2002). Under this sanction, the state removes the entire family from the grant and closes the case. Therefore, a case generally exits sanction status within a few months as either (1) the parent begins complying with TANF requirements and the benefits are reinstated, or (2) the parent continues not complying and the case is closed.
Table 2-3. Relationship of Child-Only Recipient to Head of Household, October 2000 - September 2001
|State||Total Children||Relationship to Head of Household (Percent of Child-Only Recipients)|
|Head of Household||Child||Grandchild||Other Related||Other Unrelated|
|District of Columbia||7,294||0.5||55.7||29.0||13.4||1.4|
|Sources: DHHS, 2003.|
By contrast, some states never remove the parents from the assistance unit as a consequence of work sanctioning. In these states, sanctioned cases are those in which parents fail to assist in child support procedures.
Table 2-3 presents the relationship of the TANF child recipient in a child-only case to the head of household. Nationally, the majority (63 percent) of children in child-only cases are children of the person listed as the head of household (indicating a parent present in the household). The next highest category of child-only recipients (22 percent) is that of grandchild of the person listed as the head of household. While 51.5 percent of child-only cases nationally are nonparental (Table 2-2), only 32.2 percent of children in child-only cases have relative caregivers (Table 2-3). This may indicate that child-only cases with parents present (e.g., SSI- and immigrant-headed families) have a larger number of children than child-only cases with relative caregivers. It is also noteworthy that while California, New York, and Texas all report less than half of their child-only cases as nonparental (Table 2-2), the large absolute number of total children in child-only cases in these three states (Table 2-3) means that the actual number of children living with a relative caregiver in these states may be similar to smaller states with a high proportion of nonparental child-only cases.
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|Relative care has a variety of forms, with different licensing requirements, financial supports, and service availability.|
While children living with relative caregivers may be receiving services from the TANF system and the child welfare system simultaneously, the communication between these two systems is not clearly defined. As such, a family receiving a TANF child-only relative caregiver benefit may have no contact with the child welfare system, or the child may be involved with the child welfare system at varying levels. Such dual-system involvement is not consistently tracked by states and is therefore difficult to assess.
This section defines the range of caretaking arrangements that may apply to children in TANF child-only cases with relative caregivers, and describes the eligibility and licensing requirements, financial support options, and service availability that differentiate them.
Because relative, or kinship, care has many forms, it is helpful to think of it as a continuum of interventions and support (Boots and Geen, 1999). At one end are private kinship care families, with no contact at all with the child welfare system and contact with the TANF system through a child-only grant if pursued and received. These situations usually occur when a parent arranges for a relative to care for a child for an extended period of time on an informal basis. In the middle of the continuum are voluntary kinship care arrangements, in which families are known to the child welfare system, but the child has been placed in the relative's care by the parent rather than through public agency custody. While these children are not formally a part of the child welfare system, some may be receiving support services. Both private and voluntary kinship arrangements are also known as informal kinship care, existing outside the legal authority of the child welfare system (Gleeson, 1999).
At the other end of the continuum is kinship foster care, in which relatives are caring for children in state custody and receiving ongoing attention from the child welfare system. Depending on state practice, these caregivers may receive either foster care payments or TANF child-only payments. Kinship foster care is also known as formal kinship care.
It is important to note that terminology for these arrangements varies among authors and disciplines. The distinctions among these groups reflect the various circumstances leading to the nonparental placement, as well as policy variations across state and local jurisdictions. The likelihood that children who live with relative caregivers will be supported by TANF child-only payments (rather than foster care support) will therefore vary among jurisdictions. Table 2-4 summarizes these arrangements and the estimated number of children involved in each.
The key difference between private or voluntary (informal) kinship care and kinship foster care is that children in kinship foster care (formal kinship care) are in the states' legal custody, rather than in the custody of their birth parents or relative caregivers. Caregivers in the foster care system are subject to higher eligibility requirements and supervision. Kinship foster care providers may also receive greater financial support and access to services than voluntary caregivers, although this is not uniformly true. These distinctions are described as they apply to informal kinship care and kinship foster care, in which caregivers may receive support from either foster care stipends or child-only TANF.
Eligibility. Foster parent eligibility is based on criteria defined by states within the boundaries of federal law. Requirements include training, criminal background checks, and the safety and adequacy of the physical environment. In addition, foster care imposes stringent supervision and oversight of the foster caregiver from the child welfare agency. For foster caregivers who are related to the child, most states apply somewhat less stringent requirements for licensing or approval. Boots and Geen (1999) report that 41 of 50 states responding to their survey allowed flexibility in requirements for kinship foster parents, on criteria such as physical space or training. These flexible requirements for kinship foster parents may be accompanied by reduced financial support, as discussed below.
|Kinship Care Category||Estimated Number of Children(a)||Child Welfare Involvement||Financial Support Options for Caregivers|
|Private Kinship Care||1.3 million||None; parent and relative agree on arrangement.||Child-only TANF
|Voluntary Kinship Care||300,000||May be known to agency and receive services, but parent voluntarily places child with relative. Kinship care often negotiated to avert child welfare placement.||Child-only TANF
Other state-funded support
|Kinship Foster Care||200,000||Child is in custody of public child welfare agency.||Child-only TANF
Foster care stipend
|(a): Estimates from Ehrle, Geen, and Clark, 2001.|
Eligibility for relative caregivers in child-only TANF cases is typically defined by a specified degree of relationship. Under PRWORA there is not federal law to define "relative caregivers," but rather individual state definitions. "Relative caregiver" typically includes "grandparents, siblings, stepparents, stepsiblings, uncles, aunts, first cousins, nephews and nieces," and persons of preceding generations, and spouses of any of these relatives (Mullen, 1995, page 7). In 28 states, the TANF definition of kin is different from the definition used by the child welfare agency (Janz et al., 2002). Within a single state, varying definitions may be used to define relatives with whom a child can be placed, relatives eligible for foster care funding, and relatives for purposes of TANF payment. For many, these definitions "are so confusing that caregivers cannot be expected to understand them" (Harvard Law Review, 1999, page 1057). In 21 states, the child welfare definition is broader than the TANF definition, thus placing relatives referred to the TANF office for a child-only payment at risk of receiving no assistance (Janz et al., 2002).
As with parents in parent-present child-only cases, TANF relative caregivers are neither required to participate in the work activities nor are they subject to time limits placed on a standard TANF case. Therefore, assistance for the child in a child-only case is potentially available until the child "ages out" of the program at age 18.
TANF relative caregivers are typically required to cooperate with child support enforcement activities and to meet periodically with eligibility workers for redeterminations of benefits. Generally, redeterminations take place every 6 to 12 months (depending on the state), or every 3 months in some states, if the case is receiving food stamps (Farrell et al., 2000). During the redetermination, caregivers must supply basic information about the household, although they are not required to provide information regarding income and resources.
Financial support. Financial support for relative caregivers is determined by circumstances of the placement, financial resources of the child's family, and caregiver licensing status. For children who qualify for federal foster care assistance under the standards established by Title IV-E of the Social Security Act (i.e., removal from a home that would have qualified for income assistance under the Aid to Families with Dependent Children program, and custody by a state child welfare agency), relative caregivers who are licensed foster parents are legally entitled to receive IV-E foster care payments, under the terms of Miller v. Youkim (Harvard Law Review, 1999). IV-E foster care payments are supported by a combination of both state and federal funds.
For kinship foster parents who do not fully meet the state's foster care licensing requirements, states are not required to provide foster care payments (Harvard Law Review, 1999). States may offer these caregivers either child-only TANF payments or state foster care payments, which may be equivalent to or lower than federal foster care. Because the state bears the full cost of state foster care, states have a financial incentive to use child-only TANF support, which is much less costly. Of the 41 states reporting alternative licensing arrangements for kinship foster parents, 19 offer a reduced level of support (Boots and Geen, 1999).
States also have the option of offering state-funded foster care payments for relative caregivers for placements of children who are not IV-E eligible. For example, in California, no matter what licensing standard a family meets, if the children in the relative home are not from a welfare-eligible family, the relative family cannot get a foster care payment, regardless of the relative family's own income. Missouri has even more complicated criteria for foster care payment eligibility. It specifies that all grandparent caregivers can receive a foster care payment, but any other type of relative can receive foster care payments only if they are caring for children who come from a welfare-eligible family (Farrell et al., 2000).
Kinship foster care providers thus have several possible levels of support when caring for children in state custody: federal foster care payment, state foster care payment, or child-only TANF. By contrast, voluntary kinship caregivers, who care for children who are not in state custody, typically rely on child-only TANF. Some may choose to forego financial assistance rather than apply for child-only TANF.
|Some general study findings offer insight into the well-being of this
In some states, assisted guardianship arrangements represent an alternative payment source for both formal and informal kinship care providers. As of April 2000, eight states had received federal approval to use Title IV-E foster care payments to support relative caregivers who are willing to assume legal guardianship of children in their care. Other states, including West Virginia, are using state funds to support guardianships. These arrangements provide financial support that is generally close to the level of foster care payments, with fewer licensing requirements and less intrusive supervision than kinship foster care.
Although provisions vary by state, guardianships are typically available for relatives who have already been caring for the child for a specified period of time (6 months to 2 years). Eligibility for children is defined in terms of the child's age (usually over age 12), strong attachment to the relative caregiver, and lack of options for reunification with parents or adoption. Most assisted guardianship initiatives provide financial support at the level of adoption assistance payments, which are capped at the foster care support rate. States may also provide services similar to those that would be available to families adopting foster children, including medical assistance. The goals of assisted guardianship programs include stable placements, reduced intrusion by the child welfare system into the relative caregiver's life, and reduced case management costs (DHHS, 2000). Although families typically transition to assisted guardianship from kinship foster care, some states offer this option to voluntary caregivers as well.
As with cash assistance, the availability of other supports for children in kinship care and kinship care providers vary according to the state and the type of kinship arrangement. Table 2-5 summarizes income requirements and services available to families in the different types of relative care.
|Private Kinship Care||Voluntary Kinship Care||Kinship Foster Care|
|Child Welfare Services||Not applicable||Some depending on the state and the agency||Yes but research shows they receive fewer than traditional nonkin foster parents|
|Foster Care Payments||Not applicable||No||Yes if relative becomes a licensed foster parent|
|TANF Child-Only Grants||Yes(a)||Yes||Yes if not receiving a foster care payment|
|TANF Income Assistance Grants||Yes for themselves and their own biological children if income eligible||Yes for themselves and their own biological children if income eligible||Yes for themselves and their own biological children if income eligible|
|Food Stamps||Yes must be income eligible, but relative children would be counted when determining the grant amount||Yes must be income eligible, but relative children would be counted when determining the grant amount||Yes must be income eligible, but relative children would be counted when determining the grant amount|
|Medicaid||Yes if family is income eligible or a child-only grant is being made||Yes if family is income eligible or a child-only grant is being made||Yes all foster children are categorically eligible|
|SSI||Yes if relative child meets disability guidelines||Yes if relative child meets disability guidelines||Yes if relative child meets disability guidelines and a foster care payment is not being made for that child|
| (a): Wisconsin's TANF program
converted child-only payments to kinship care payments; families were only
eligible if the child was determined to be at risk of harm if living with
his or her biological parents. Child welfare agencies assess all families
applying for payment.
Sources: Ehrle, Geen, and Clark, 2001.
Because the children in kinship foster care receive services and are monitored through the child welfare system, more research has been conducted assessing their well-being (Janz et al., 2002; Scannapieco and Hegar, 1999). By contrast, little research has been conducted assessing the well-being of children in TANF child-only cases, generally, and relative caregiver child-only cases, specifically. The following section reviews research on the well-being of children in relative care.
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Relative care comprises the largest single category of child-only TANF grants nationally, with approximately 50 percent of child-only grants going to kin (DHHS, 2003). National data indicate that this trend is not isolated to the TANF population and that increasing numbers of children in both the TANF system and the child welfare system are being cared for by kin. According to the 1997 National Survey of America's Families (NSAF), 1.8 million children were in kinship care arrangements (Ehrle, Geen, and Clark, 2001). By 2000, this number grew to approximately 2.3 million children (Billing, Ehrle, and Kortenkamp, 2002; Edelhoch, 2002). The rise in kinship care is attributed to a number of factors: the decline in the supply of traditional foster homes; the contemporaneous increase in the need for out-of-home placement for children; the movement in child welfare services favoring kinship care; and changes in funding practices for kin (Berrick and Barth, 1994; DHHS, 1998; DHHS, 2000). PRWORA authorized states to give preference to kin when placing foster children (GAO, 1999).
A better understanding of relative care is helpful in understanding its potential impact on child well-being in child-only cases. Much of the research to date on relative care does not focus on children who receive child-only TANF grants, but rather on children in kinship care through the child welfare system. While children receiving child-only TANF grants are sometimes included in studies of relative care, they are very rarely isolated for analysis, making any findings difficult to attribute to the TANF child-only experience. However, some general findings regarding relative care and child well-being offer insight into the well-being of children in TANF child-only cases with relative caregivers. These findings are presented below.
The origins of child-only cases have a direct bearing on the well-being of children in these cases. Sanctioned-parent, SSI-parent, and immigrant-parent cases are created by circumstances that leave families intact. In contrast, the origins of nonparent child-only cases are more complex and potentially more distressing (Wood and Strong, 2002). These children are not living with their parents, but with relatives who have taken on the responsibility of raising them. Children in nonparent child-only cases often have parents with serious personal problems that make it impossible or inappropriate for them to raise their children. It is important to note that there may be multiple reasons why the child is living with a nonparent caregiver. For example, the parent(s) may
Each of the situations can cause emotional and physical distress to a child. While placement with a relative caregiver provides some immediate stability and support for the child, the child remains at risk for emotional and behavioral problems.
Placement with a relative is usually seen as the best alternative when out-of-home care is necessary (Edelhoch, 2002). States have been giving preference to relatives when placing children outside their parental home since the mid-1990s (Edelhoch, Liu, and Martin, 2002). In an environment where foster care availability is declining, relative care offers states an essential and critical alternative. In addition, many caseworkers also believe that placement with relatives is in the best interest of the child (DHHS, 1998). Possible advantages of placement with relatives include facilitation of identity formation, preservation of family ties, and increased visitation. In most relative caregiver cases, the children have suffered emotional trauma in separating from their parents. While relative placement is no substitute for parental care, it is viewed generally as one of the best alternatives for out-of-home placement (Edelhoch, 2002; Berrick Barth, and Needell, 1994; Christian, 2000).
Placement stability for children in out-of-home care has long been a concern of researchers (Bernstein, 2002; Webster, Barth, and Needell, 2000; Anderson-Moore, Vandivere, and Ehrle, 2000). With each change in placement, children may experience an increased sense of rejection and impermanence. Nearly 30 percent of children in kinship care through the child welfare system experience placement instability, defined as three or more moves after the first year in care (Webster, Barth, and Needell, 2000). This does not appear to be the case, however, with children in TANF child-only relative care. Over 90 percent of relative caregivers for TANF child-only cases in South Carolina reported that they would like to raise the child (or children) placed with them until the age of 18 (Edelhoch, 2002). A study in New Jersey found that, although the lives of children in child-only families have been disrupted by removal from the home, their relative care placements are typically long term and stable (Wood and Strong, 2002). Investigation of North Carolina's child-only cases found that 82 percent of the nonparental child-only cases reported children having lived with the caregiver continuously since last living with the biological parent (Duncan, 2002).
Children in nonparent child-only cases often have parents with serious personal problems that make it impossible or inappropriate for them to raise their children. Drug addiction is particularly common. In New Jersey, 6 in 10 caregivers reported that the child's mother had a substance abuse problem that made it impossible for her to raise the child (Wood and Strong, 2002). It has also been reported that many children in nonparental TANF child-only cases have been victims of abuse or neglect and are thus also involved with the child welfare system (Edelhoch, 2002; Wood and Strong, 2002; Ehrle, Geen, and Clark, 2001; Farrell et al., 2000; Schofield and Fein, 2000).
Many children entering the TANF system do so through referrals from the child welfare system (Greenberg et al., 1999). Children removed from the home due to abuse or neglect are typically first placed through the child welfare system and then (if the relative caregiver is not a licensed foster parent) referred to TANF for financial assistance. Other traumatic experiences leading to children not living with their parents include parents' criminal activity, lack of money, or mental health problems. In addition, children placed in relative care often have experienced not only one of these circumstances, but have been exposed to multiple traumatic experiences prior to placement out of the home.
Children who live with relatives or foster parents are more likely to have behavioral and emotional problems than children who live with their parents (Kortenkamp and Ehrle, 2002; American Academy of Pediatrics, 2000; Simms, Dubowitz, and Szilagyi, 2000). Analysis of the 1997/1999 NSAF found significant differences between children in kinship or foster care and children cared for by parents in terms of limiting conditions and physical health status. A higher percentage of children in kinship and foster care reported having physical or mental impairments, being in fair or poor health, and visiting a mental health provider during the survey year (Kortenkamp and Ehrle, 2002). In a study of kin caregivers in South Carolina, relatives reported that the children they cared for suffered from "nightmares, anxiety attacks, depressionàlearning disabilities, promiscuity, and/or aggressive behavior," much of which was likely caused by past trauma (Edelhoch, 2002). While physical and emotional health is a concern of children placed in TANF child-only relative care, states are addressing this concern through policies tying cash assistance to compliance with immunization schedules and/or well-child medical visits (Romero et al., 2001; Risely-Curtiss and Kronenfeld, 2002). However, even with this tie to cash assistance, physical and emotional health care is in question. Risely-Curtiss and Kronenfeld (2002) found that fewer than 50 percent of referrals for physical, dental, and mental health care were completed by relative caregivers within a reasonable time frame.
Compared to children who live with their parents, a significantly higher percentage of children who live with relatives or foster parents have been suspended or expelled from school and fewer are involved in school activities (Kortenkamp and Ehrle, 2002; Billing, Ehrle, and Kortenkamp, 2002). A survey of teachers found that children in kinship care compared to other students had poor study habits and lacked the ability to pay attention and concentrate (Dubowitz et al., 1994). Additionally, children living with relatives were reported as being less involved in school activities than children living with their parents (Billing, Ehrle, and Kortenkamp, 2002). This finding is important because involvement in activities such as sports, lessons, and clubs has been shown to help children by enhancing social skills and enabling personal accomplishment (Ehrle and Moore, 1999).
Researchers report differing findings regarding the financial status of TANF child-only relative care cases. For example, recent research indicates that child-only relative care cases typically are less disadvantaged and have more income than a standard TANF case (Wood and Strong, 2002; Farrell et al., 2000). Schofield and Fein (2000), however, found that while child-only relative caregivers report higher earnings than parental caregivers, their total earnings average well below the poverty line. These financial barriers, if present, may be serving as obstacles to obtaining and providing physical and emotional health care. While children in TANF child-only relative care are eligible for Medicaid, long delays can occur between the time a child is removed from his or her home and Medicaid approval, during which time the child may not be covered by Medicaid (Risely-Curtiss and Kronenfeld, 2002). Health care access may also be limited because not all providers serve Medicaid patients and some types of services are not covered. With reimbursement rates for TANF grants averaging less than half of the reimbursement rate for foster care in most states (Wood and Strong, 2002; Farrell et al., 2000; Schofield and Fein, 2000), covering the additional medical and behavioral expenses of a child can become overwhelming to a relative caregiver on a fixed income.
Relative caregivers also face expenses associated with school, including clothes, uniforms, books, supplies, and field trips (Edelhoch, 2002). These needs are especially critical as school engagement is reported to be poor among this population.
Since eligibility for TANF benefits is no longer a federal entitlement, states have the option of not offering child-only grants or imposing limitations such as waiting lists on child-only grants. However, all states are currently offering some type of child-only grant, without waiting lists. Benefit levels have always varied among states, even under the former TANF program, benefit levels varied among states. Under the current TANF program, however, states have greater flexibility to change benefit amounts or offer new combinations of benefits (e.g., without first having to submit a plan for approval to the federal government).
In summary, a substantial body of research has shown that children in relative care typically come from unstable environments and have often been exposed to multiple traumatic experiences (e.g., abuse, neglect, substance abuse). Compared to children in parental care, children in relative care have greater physical and emotional needs, perform more poorly in school, and experience economic hardship. However, even with these concerns, it is possible that these potentially damaging developmental risks might be moderated by the benefits (e.g., emotional attachment, permanency) of living with a relative (Altshuler and Gleeson, 1999).
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Regardless of the arrangements under which they care for children, relative caregivers frequently do so without financial support. While relatives have always been able to receive child-only grants, many (especially those in "informal" kinship arrangements) do not know that this help is available. The Urban Institute estimates that only 28 percent of all children in child welfare kinship care placements receive either a child-only TANF or foster care payment (Ehrle and Geen, 2002).
For those who do receive financial support, child-only TANF arrangements provide minimal services and less money than foster care, even though the circumstances that bring these children to kinship care may be similar. In South Carolina (Edelhoch, 2002), the base rate for foster care payments per month for one child without special needs aged 6 to 12 years is $339 per month; the TANF payment to a relative caregiver for one child is 70 percent less - $102 per month. Additionally, TANF payments decrease for subsequent children, while the foster payments are the same for each additional child. Finally, while foster parents are eligible to receive quarterly clothing allowances, no such provisions are made for relative caregivers in child-only cases.
Therefore, while service needs of TANF child-only relative caregivers vary, one critical need is financial support. This support is essential as relative caregivers in TANF child-only cases tend to take in children at a time in the caregivers' lives when they may be retiring or they are at least past the child-rearing stage (Ahmann and Shepherd-Vernon, 1997). In a study of relative caregivers in South Carolina, some were spending retirement savings or postponing retirement in order to provide for kin in their care (Edelhoch, 2002). Having unexpected children to care for on a limited income has an impact on the relative caregiver in terms of providing adequate housing, providing food, and finding daycare (Ehrle and Geen, 2002).
Additionally, children in TANF child-only relative care often face physical and emotional challenges. As noted in the previous section, children in TANF child-only relative caregiver cases may feel abandoned and have serious physical and mental health care needs that require immediate and ongoing attention (Ahmann and Shepherd-Vernon, 1997; Christian, 2000). The service needs of these children in child-only cases will differ depending on the specific circumstances preceding placement, the resiliency of the child, and the relative support within the home. While not all children in child-only cases will need additional services such as mental health counseling or anger management classes, many of these children may be at risk for physical and emotional problems.
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Because of the very different types of family structures found among the child-only caseload, designing appropriate interventions to serve such families is complicated (Kaplan and Copeland, 2001). States have had to assess their child-only caseload individually and determine what programs or services were needed to address the particular concerns. For the most part, states that have developed a program to address child-only service needs have focused on the needs of the relative caregivers rather than on those of children. In a study of child-only policies and practices in three states - California, Florida, and Missouri - no special efforts were being made in 1999 to serve child-only cases (Farrell et al., 2000). However, in light of the increasing proportion of child-only cases, several states are looking more closely at the needs of the child-only caseload.
While child-only cases are growing in proportion and are becoming more prominent in welfare literature, the approach for addressing these cases is still at the complete discretion of the state. As stated earlier, child-only grants are not considered an entitlement as states are not required to offer the grant or may offer it with limitations such as a waiting list for services. All states are currently offering some type of child-only grant; however, it is important to note that states are not required to offer child-only grants at all and can cap payments to families at any time or implement a waiting list for assistance (AARP Grandparent Information Center, 1997).
To determine the extent to which child-only cases were addressed in annual state TANF plans, study staff reviewed each state plan for reference to child-only cases. Researchers created categories of references to organize these findings, which are summarized in Table 2-6. These categories include
The study team acquired state TANF plans for all 50 states and the District of Columbia. In 13 of these plans, no reference was made to child-only cases. However, the lack of any mention of child-only cases in the state plan does not necessarily indicate a lack of programs in that area. In fact, since all of the states report on the number of their child-only cases, it is clear that they have programs that offer cash grants, with or without additional services. There is currently no federal required format for TANF State Plans. As such, each individual plan varies greatly in the format and the amount of detail included. Among the remaining 35 state plans, administrative references were the most common (in 22 plans), followed by definitions and cash-grant references (16 plans each). Fourteen plans included a specific reference to a program addressing the needs of kinship care families.
A critical issue for states to be able to better assess their needs regarding child-only cases is the ability to clearly describe their state's TANF caseload composition, specifically the types and proportions of child-only caseloads currently in their state. During telephone conversations with Administration for Children and Families (ACF) Regional Administrators, study staff asked regional and state representatives questions regarding the state-specific TANF caseload composition. Additionally, project staff inquired if child- only cases were increasing, decreasing, or remaining stable in recent months. Finally, researchers inquired as to the presence of any state-specific collaboration efforts between the TANF system and the child welfare system.
(e.g., participation calculation)
|Cash Grant||Kinship Care Program||No Reference|
|District of Columbia||X|
|Sources: State TANF plans.|
Table 2-7 summarizes the child-only proportion of each state's TANF caseload (DHHS, 2003) and the information communicated by ACF Regional Administrators regarding child-only trends and practices by state. Regional Administrators often had difficulty assessing if child-only cases were increasing, decreasing, or remaining stable in the states in their regions. Some of the difficulty in making this assessment stemmed from a lag in data reported to the state or federal offices. As a result, the information reported below is often based on a state or region's "impression" of the stability of their child-only caseload and not on empirical data.
|Proportion TANF Caseload That is Child-Only||Majority Type of Child-Only Cases||Percentage of Child-Only Cases||Collaboration with Child Welfare System|
|Alabama||51.6||Parental SSI Nonparental||X||X|
|Arizona||45.4||Unable to Determine||X||X|
|California||41.5||Unable to Determine||X||X|
|Connecticut||34.6||Unable to Determine||X||X|
|Delaware||43.5||Unable to Determine||X||X|
|District of Columbia||26.2||Unable to Determine||X||X|
|Indiana||22.0||Unable to Determine||X||X|
|Iowa||23.9||Unable to Determine||X||X|
|Kansas||32.9||Unable to Determine||X||X|
|Louisiana||46.2||SSI parental Nonparental||X||X|
|Maine||24.4||Unable to Determine||X||X|
|Mississippi||49.5||Parental SSI and Nonparental||X||X|
|Missouri||27.2||Unable to Determine||X||X|
|Montana||20.7||Unable to Determine||X||X|
|Nebraska||34.1||Unable to Determine||X||X|
|New Hampshire||28.3||Unable to Determine||X||X|
|New Mexico||21.3||Unable to Determine||X||X|
|New York||28.3||Nonparental and Parental SSI||X||X|
|North Carolina||50.9||Parental SSI||X||X|
|North Dakota||26.6||Parental Immigrant||X||X|
|Ohio||44.7||Unable to Determine||X||X|
|Pennsylvania||32.1||Unable to Determine||X||X|
|Rhode Island||18.2||Unable to Determine||X||X|
|South Dakota||55.5||Parental Immigrant||X||X|
|Texas||34.1||Nonparental Parental Immigrant||X||X|
|Vermont||17.1||Unable to Determine||X||X|
|West Virginia||29.4||Parental SSI||X||X|
|Wyoming||70.4||Unable to Determine||X||X|
|Sources: DHHS, 2003; personal communication with ACF Regional Administrators.|
As a result of the increasing proportions of child-only cases with relative care in some states, initiatives are being developed to connect child-only families with needed prevention, treatment, and support services. While some of these programs are targeted specifically to child-only cases, some are targeted to kinship care cases in general (including those not receiving a child-only grant). Two prominent studies have investigated state initiatives: "Addressing the Well-Being of Children in Child-Only Cases" by Kaplan and Copeland (2001) and "On Their Own Terms: Supporting Kinship Care Outside of TANF and Foster Care" by Geen et al. (2001). Study staff used these two documents, in conjunction with information obtained during discussions with Regional Administrators, to compile a list of some of the programs and initiatives targeted to child-only cases and kinship care. These initiatives were then categorized by type of program or initiative focus.
Supplemental Financial Support
Colorado - Denver. In Denver, the TANF division of the Department of Human Services provides a supplemental child-only TANF payment and other supports to relatives caring for kin through their Grandparents and Kinship Care Program. With the additional cash assistance, the amount of the child-only payment is similar to the foster care monthly payment.
Florida. Under the Relative Caregiver Program, nonparent relatives can receive a cash payment each month to cover the cost of the child's basic needs. The payments are a maximum of $242 for children ages 0 to 5, $249 for children ages 6 to 12, and $298 for children ages 8 to 13. Eligibility is based on child's age, income, and other eligibility criteria. The relative must have a juvenile court order placing the child in their home under protective services.
Kentucky. The Kinship Care Program was initiated to administer services under the Kentucky Cabinet for Children and Families (an umbrella agency responsible for both child welfare and TANF). The Kinship Care Program provides greater financial support and services to nonparent relative caregivers. The program uses TANF funds, and the monthly payment is $300 per eligible child. The income and resources of the relative are not considered. The program aims to provide an amount closer to that of a licensed foster parent to kin caring for children who have been abused or neglected without requiring the relative to become a foster parent. Under the program, the relative assumes temporary custody of the adjudicated child and must agree to accept permanent legal custody of the child if reunification with the parent(s) is not an option.
Michigan. The Kinship Care and Family Preservation pilot project provides increased financial support, emergency financial payments, and community linkages to children ages 0 through 18 who are residing with a self-supporting relative caregiver. The caregiver must have petitioned for or been awarded guardianship of the child.
Missouri. The Grandparents as Foster Parents Program assists with payments equal to 75 percent of the foster care rate. Eligibility requirements include having legal guardianship and being at least 55 years of age.
Nevada. Nevada has two programs relative to child-only cases. The first is for nonneedy relative caregivers and includes a payment of $187 more per month for a child in relative care than through the regular TANF payment scale.
New Jersey. New Jersey has a program under Income Maintenance in the Division of Family Development that provides a $250 maintenance payment. This payment is midway between the regular TANF payment and the foster care payment.
Oklahoma. Oklahoma has implemented a Support Services Fund through the child-only TANF program. These funds are specifically targeted to child-only relative caregiver families. The funds can be used to supplement the child-only cash grant to purchase items such as clothing, school supplies, and sports registration fees.
Supplemental Services Support
Ohio. Ohio, through their Department of Jobs and Family Services, developed a Statewide Kinship Caregiver Services Program. The Program was developed based on recommendations in an agency task force report on grandparents raising grandchildren. The program offers subsidized child care, respite care for the caregiver, legal assistance, and training on how to deal with children with special needs. Additionally, a toll-free number is available for caregivers to call for information and referrals to services.
Pennsylvania. A nonprofit kinship foster care agency, A Second Chance, housed in Pittsburgh is working to address the needs of relative caregivers through a comprehensive approach to family issues and permanency. Families come to the agency through referrals from the County Department on Human Services after the child has been adjudicated as abused or neglected and placed with the relative. The agency works with the birth parent, the child, and the relative to address family issues and develop a permanency plan, recognizing that kinship care families have different needs than traditional foster care families.
Coordination between TANF and Child Welfare Systems
Colorado - El Paso. In El Paso County, the Department of Social Services (DSS) has worked to blend TANF and child welfare services educating relative caregivers about other services (e.g., child-welfare services). They have also prioritized kinship care for child welfare services, and the Director of the DSS has created a flexible pot of TANF dollars to meet identified needs of families with children in kinship care.
Wisconsin. The State of Wisconsin administers a Kinship Care program through the Department of Health and Family Services (the state child welfare program). Wisconsin offers a kinship care benefit of $215 per month for children in relative care. The caregiver need not be eligible for TANF to receive this benefit.
Lower Income Families
Alabama. Alabama initiated a KinShare Pilot Program targeting vulnerable families with incomes less than or equal to 200 percent of the poverty level. Their focus is on families in which the children are at risk of foster care placement. Services are available to help stabilize an existing placement with a nonparent relative. The target population is families receiving child-only TANF cash assistance benefits and families identified through the child welfare program. Services include child care, respite care, special needs payments, emergency intervention services, and counseling. The pilot began in one county in October 2000, and has expanded to five additional counties.
California. California implemented a Kinship Guardianship Assistance Payment (Kin-GAP) program. It is intended for children exiting the foster care system and entering a guardianship with a relative. To be eligible, the child must have lived with the relative for at least 12 months and relative guardianship must be established. Other requirements are similar to those of California Work Opportunity and Responsibility to Kids (CalWORKs) and are based on financial need.
Louisiana. The Kinship Care Subsidy Program (KCSP) provides cash assistance for eligible children who reside with qualified relatives other than parents. Qualified caregivers must have incomes below 150 percent of the poverty line and have legal custody or guardianship. The KCSP subsidy payment is $222 per eligible child per month.
Nevada. The Kinship Care program is similar to the nonneedy relative program but offers even more of an increase in payment per month (a payment equal to 90 percent of the state monthly foster care rate). To qualify for this program, the relative caregiver must be over 62, have a minor child placed in their care for at least 6 months, and obtain legal guardianship of the minor relative child.
Relative Support Groups
Kentucky. Kentucky has a KinCare Project that is a statewide network of over 25 kinship care support groups. The meetings are held in Resource Center offices housed in public schools throughout Kentucky.
Oklahoma. Oklahoma's Aging Services Division sponsors an annual conference on grandparents raising grandchildren. The conference provides grandparents with information on state services such as child welfare and TANF. The Aging Services Division also funded a resource handbook for grandparents and distributed it at the conference.
Kinship Navigator Program
New Jersey. New Jersey implemented a Kinship Navigator Program designed to help caregivers navigate government services, such as TANF, food stamps, Medicaid, health insurance, and child care. The navigator assists with case management activities and can provide referrals to such support services as rental or utility assistance.
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Child well-being is one of the concerns of programs serving children and families (e.g., TANF and child welfare). Policy makers need timely data about the status of children, specifically for those children in child-only cases as the proportions of these cases continue to rise nationally.
Much more information is needed on the status of children in TANF child-only relative caregiver cases. The well-being of these children is currently unknown and typically unmonitored. The service needs of these children may differ from standard TANF services (e.g., food stamps, child care benefits, transportation) that often address the needs of the caregiver more than of the child. To date, attention has been given to the needs of the caregiver (both parental and nonparental) toward a goal of stable placement for the child. While this is a worthy and critical goal, the service needs of children, specifically those removed from their homes and placed in relative care, go far beyond a residence. Accordingly, the next chapter analyzes the data from the two national surveys in an attempt to increase our knowledge about the service needs of children in TANF child-only cases with relative caregivers.
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Human Services Policy (HSP)
Assistant Secretary for Planning and Evaluation (ASPE)
U.S. Department of Health and Human Services (HHS)